Abstract

Background Data from Arab world studies suggest that Arab women may experience a more aggressive breast cancer phenotype. To investigate this finding, we focused on one of the largest settlements of Arabs and Iraqi Christians (Chaldeans) in the US, metropolitan Detroit- a SEER reporting site since 1973. Materials and methods We identified a cohort of primary breast cancer cases diagnosed 1973–2003. Using a validated name algorithm, women were identified as being of Arab/Chaldean descent if they had an Arab last or maiden name. We compared characteristics at diagnosis (age, grade, histology, SEER stage, and marker status) and overall survival between Arab–, European–, and African–Americans. Results The cohort included 1,652 (2%) women of Arab descent, 13,855 (18%) African–American women, and 63,615 (80%) European–American women. There were statistically significant differences between the racial groups for all characteristics at diagnosis. Survival analyses overall and for each SEER stage showed that Arab–American women had the best survival, followed by European–American women. African–American women had the poorest overall survival and were 1.37 (95% confidence interval: 1.23–1.52) times more likely to be diagnosed with an aggressive tumor (adjusting for age, grade, marker status, and year of diagnosis). Conclusion Overall, Arab–American women have a distribution of breast cancer histology similar to European–American women. In contrast, the stage, age, and hormone receptor status at diagnosis among Arab–Americans was more similar to African–American women. However, Arab–American women have a better overall survival than even European–American women.

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Acknowledgements

This work was supported by a Department of Defense Breast Cancer Research Program Predoctoral Fellowship (W81XWH-04-1-0395 to SHA), by grants from the Breast Cancer Foundation (SDM) and the Burroughs Wellcome Fund (SDM), and the National Institutes of Health through the University of Michigan’s Cancer Center Support (5 P30 CA46592 to SBG and SDM). The funding sources were not involved in the study design or data collection, analyses, or interpretation. The authors had full responsibility of the writing of the manuscript and the decision to submit for publication.